女子キーパンチャーの指尖plethysmogramについて

Abstract

Finger pulse wave was recorded in 144 womens consisting of 100 key-punchers, 24 normal control and 20 patients with scalenus syndrome, by means of a pneumatic strain gauge transducer plethysmograph. The contour of pulse wave was classified in six groups, vis. catacrotic, peak flat, anacrotic, sclerotic rigid, vasospastic and plateau. Geometrical analysis of the pulse wave was carried out, eight indices being adopted. Percentages of the normal pattern of the pulse wave, comprised of catacrotic plus peak flat wave, were ca. 85% in the normal control group, ca. 35% in patients with scalenus syndrome, and ca. 45% in key-punchers. Whereas, those of vasospastic wave plus plateau wave, which is said to represent the spasm of peripheral vessels, were ca. 35% in key-punchers, 6% in the control group and 20% in patients with scalenus syndrome. In the finger pulse wave of key-punchers, a statistically significant decrease of elasticity index, a significant increase of dicrotic index, relatively descending time at the half-way of the peak amplitude, and that of relative amplitude at the half-way of the diastolic phase, and the reduction of peripheral blood flow were observed. The finger pulse wave of key-punchers with complaints represented neurovascular symptoms such as pain, numbness, hyperaesthesia and coldness of the hands, arms and shoulders or the neck, showed only the prolongation of relative ascending time at the halfway of the peak amplitude compared with that of the key-punchers without complaints. Both geometrical analysis and wave form of the finger pulse wave of key-punchers revealed no significant difference in the arms with and without complaints. The finger pulse wave of punchers engazed in key-punching over 10 years indicated a tendency to increase in peripheral vascular resistance, such as the increase in the dicrotic index and the relative descending time at half-way of the peak amplitude, the decrease of the elasticity index and the shorting of the propagation time compared with the group of key-punchers whose length of service are less than 10 years. When the modified Adson's maneuver (elevation of the chin, looking toward right and left side alternatively) was employed in subjects, no significant change was found in geometrical analysis of the finger pulse wave of both the key-punchers and of the control. In the scalenus syndrome group, however, the increase of the relative descending time at half-way of the diastolic phase was observed when the patients rotated his neck to the left side as well as a significant reduction of peripheral blood flow when rotated to the right or the left side. When key-punchers, whose pulse wave classified as vasospastic and plateau type, lay on their back with arms raised so high as 90 degrees in the angle for 30 seconds in the duration, contours of the finger pulse changed from vasospastic or plateau wave to the normal wave (catacrotic or peak flat). Therefore, peripheral hemodynamics of the key-punchers was manifested as vasoconstrictive and its cause would not likely be organic but rather functional. The vasconstriction of the finger, estimated from the finger pulse wave, was more prominent in the group of key-punchers engaged in key-punching more than 10 years and this appeared to be independent of their complaints.